Please take a moment to familiarize yourself with this form. The information required to complete this form is fairly extensive and may require some additional thought as you answer the questions. As such, you may want to make some notes prior to filling out the questionnaire. Information entered and not submitted will not be saved.

Please fill in the information below as applicable to your business. After completion, please submit using the Send To Programming button at the bottom of the form. If you have your own script and/or protocols already typed, you may send that in addition to this document, but please make sure that you include as much of the information below as possible.

Please note: our programmers will assess your setup information once it has been received, then notify you with an estimated completion date.

Building Your Account

Please help us start building your custom account! We use scripted software, so the answers to these questions can be quite specific and conform to the nature and needs of your business!

What information should we collect from a caller for routine matters? (If applicable)

What information should we collect from a caller for emergency / urgent matters? (If applicable)

Are there any special instructions with regard to what types of messages we should or should not take, and/or dispatch to the person on-call?

Does your office use an On-all schedule?

We have the ability to program your schedule in advance – OR – we can allow your business to have access to our secure web portal, where you are able to program your own on-call information! Please contact us for additional information.

Please provide any that apply: Staff names & numbers (Home, Cell, etc.), the procedure/order in which to call them, how long to wait between each dispatch attempt, etc.

On-Call staff information and procedures can be attached as a separate list or document below or sent separately.

Please note: We offer an enhanced texting option with delivery/read options that is also secure and HIPAA compliant. It enables our staff to see when/if the message has been read, and escalate if there is no response. Please contact us for additional information.

Please note: complex changes made during the initial setup/programming process could delay the start date and/or incur additional programming fees.

When finished completing form, please click here to submit. Thank you!